Mark McClanathan opens a locker in the family's kitchen where all potentially dangerous household items, including scissors, knives, medications and junk food, are kept under lock and key, as his wife Carmen speaks with their son, Nov. 17, 2016. Two years ago their 14-year-old daughter began showing signs of mental illness and suicidal tendencies. Almost overnight she was hospitalized, diagnosed with borderline personality disorder, and spent much of the following nine months at an adolescent psychiatric facility in Nevada. There are currently no long-term facilities for adolescents in Washington state. She has just recently been able to begin attending school again. less

Mark McClanathan opens a locker in the family's kitchen where all potentially dangerous household items, including scissors, knives, medications and junk food, are kept under lock and key, as his wife Carmen ... more

Photo: GENNA MARTIN, SEATTLEPI.COM

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Sixteen-year-old B. drinks the milk out of her cereal bowl as her parents, Mark and Carmen McClanathan, talk in their kitchen, Nov. 17, 2016.

Sixteen-year-old B. drinks the milk out of her cereal bowl as her parents, Mark and Carmen McClanathan, talk in their kitchen, Nov. 17, 2016.

Scars from self-harm are visible on B.'s arm. The 16-year-old was hospitalized for nine months over the past two years for borderline personality disorder and suicide attempts. On multiple occasions, she swallowed bottles of shampoo, a tube of toothpaste, batteries, a full bottle of lithium, and tried to strangle herself with her own pants. Dialectical behavioral therapy (DBT) has allowed B. to return to school recently and live a more normal life. less

Scars from self-harm are visible on B.'s arm. The 16-year-old was hospitalized for nine months over the past two years for borderline personality disorder and suicide attempts. On multiple occasions, she ... more

Photo: GENNA MARTIN, SEATTLEPI.COM

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B. shops for makeup on her phone, Nov. 17, 2016.

B. shops for makeup on her phone, Nov. 17, 2016.

Photo: GENNA MARTIN, SEATTLEPI.COM

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B. watches "The Office" and plays with her younger brother in their home, Nov. 17, 2016.

B. watches "The Office" and plays with her younger brother in their home, Nov. 17, 2016.

Photo: GENNA MARTIN, SEATTLEPI.COM

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Carmen McClanathan, right, talks about school with her daughter B., Nov. 17, 2016.

Carmen McClanathan, right, talks about school with her daughter B., Nov. 17, 2016.

Photo: GENNA MARTIN, SEATTLEPI.COM

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Sixteen-year-old B. draws at the kitchen table, Nov. 17, 2016.

Sixteen-year-old B. draws at the kitchen table, Nov. 17, 2016.

Photo: GENNA MARTIN, SEATTLEPI.COM

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B.: Sixteen, suicidal and living with it

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“Some people joke about it like it’s nothing. It’s sad.

“I’m trying to think of a way to make it dramatic, like a headline for your thing.” B. says after I ask her – poorly, she tells me – what you should know about her unusual mind.

“Are you ashamed?” prods B.’s mom, Carmen McClanathan.

“Nooooooooooo!” B. bawls, faking exasperation at having to give her mom the answer everyone knew was coming.

It’s a joke and a dodge. Her mom calls them her shenanigans. They are hilarious.

At 16, B. is gregarious, a crackup. She kids about everything. Her birthday brownies. Old ladies at the nail salon. Her stepdad’s singing.

B.’s story isn’t as funny as she is. Carmen, husband Mark and B. have found the humor in it. Mostly, though, it’s been terror followed by frustration followed by more terror.

“We went from zero to suicidal overnight,” Carmen says.

This was about two years ago. B. told her boyfriend she was suicidal. Her boyfriend told his mom, who told Carmen. B. was cutting herself and had a plan for how she would end her life, so, in March 2015, her parents took her to Fairfax Behavioral Health, a private, 160-bed psychiatric hospital in Kirkland.

Carmen says she thought they’d go in, get some antidepressants and head home.

B. was hospitalized for nine months.

Fairfax was good for B. in that it kept her safe, but it wasn’t a place to stay for long. And, because Washington has few long-term psychiatric facilities for children, B. was off to a secure facility in Reno, Nevada.

She didn’t stop trying to kill herself at Willow Springs Center. She ate tubes of toothpaste and downed bottles of shampoo. She cut herself and struggled as her parents waited hundreds of miles away.

The residential treatment center gradually gave her and her parents the tools she uses to live with her illness, diagnosed as borderline personality disorder.

Where to call for help

Crisis Clinic 24-Hour Crisis Line866-427-4747

Living with borderline means enduring emotional upswings that climb out of control. Carmen said people with her daughter’s condition escalate hard and quickly. And they come down very, very slowly. The residue of frustration and disappointment builds up until they break down.

Waking up in the morning is enough to ruin B.’s day. Little disappointments land like punches for her. Her parents have retired “no” from their parental arsenal.

“People with what she has do really big things when they want something,” Carmen said. “And they’re not good things.”

And then B. needed to come home. The insurance wasn’t going to pay anymore. Before that could happen, though, her parents needed a plan.

B. couldn’t just show up at high school. There was supposed to be a medical team in place before Willow Springs would release her. That her parents couldn’t find one after weeks of trying didn’t change much.

Carmen flew to Reno and returned with her daughter. B. didn’t last 24 hours.

She was back in a hospital after downing a bottle of slow-release lithium tabs hours after her parents picked it up.

“If you’ve never had someone living in your house with any kind of mental problems, you don’t know,” Carmen said. “It’s trial and error.”

All things sharp, poisonous or binge-able in the McClanathans' household now live in a 6-foot-tall metal locker standing in their kitchen. B. doesn’t have a key.

The day she wolfed down the lithium, B. ended up at Seattle Children’s intensive care unit and eventually matriculated to the hospital’s inpatient mental health program. And, again, she was stuck.

Like its counterpart at Willow Springs, Children’s couldn’t find a psychiatric team to take on B. The wait lists for the kind of care she needed – dialectical behavior therapy – were extreme.

The Seattle group offering DBT couldn’t take B., a girl who had lasted less than a day last time, for six months. Impossible waits like that were the norm, Carmen said, for psychiatrists and other assistance as well.

The McClanathans' struggle to find care for B. isn't exceptional. About 140,000 Washington children have mental illnesses or developmental issues, but just half of them are receiving care.

Estimates indicate 56,000 Washington children have experienced what are termed “major depressive episodes,” weeks-long bouts of depression that can lead to suicide. Only New Mexico has a higher rate.

B.’s mother eventually found a group in Kirkland that, miraculously, had room. B. got to go home again.

Since then, B. has been back in the ER a few times but her parents have been able to keep her out of the institutions since she was released from Children's in November. She ends up in trouble when she becomes, as her parents have learned to call it, “dysregulated.”

“It’s hard to explain,” says Carmen, clustered with Mark at their high kitchen table as B.’s younger brothers buzz around the Bothell townhouse.

Keeping B. regulated is as good as it gets for now. Regulated, B. can go to school. She can live long enough to stabilize and survive her disease.

“She is suicidal every day of her life,” Carmen says. “She doesn’t act on it. She understands that’s not the way to go. But it does cross her mind every day. …

“There is no cure for what she has. People with borderline, this is who they are. This is how they’re going to be. You’re going to have to live with it.”

B. likes English. She’s reading “The 5th Wave” – “10 out of 10,” she effuses. She wants to teach it in Saudi Arabia, she says, to help girls who don’t have the opportunities she does.

Genna Martin, the seattlepi.com photojournalist who made the images included here, asks B. what she’d say to people who were where she was two years ago -- people hurting themselves and struggling with suicidal impulses.

“I like to go by Nike’s famous quote, ‘Just Do It,’” B. says with conviction.

Oops.

“Don’t do the bad thing!” she giddily corrects, laughing now. “Do the opposite. … Once I relapsed a few times, I realized, ‘Don’t Do It.’”

“What about your friends at school who are going through hard times?” Carmen asks her daughter. “What do you tell them?”

“I don’t really tell them anything. You don’t just walk up to someone and say, ‘Hey, stop cutting.’ … Everyone is trying their best to be happy. Even if they’re being a jerk. They are just trying to be happy.”

NOTE TO READERS: At the McClanathans' request, including B.'s, I opted not to use her full name in this piece. They, and I, were concerned that doing so could reinforce the misconception that mental illness is something to hide or fear. That stigma exists, though, and B. has already done more than her share to fight it by offering up her story.